{"id":"d65f11aa4aa4","type":"article","url":"https://hartvaat.nl/2025/06/09/tino-stents-versus-des-bij-acs-ipd-meta-analyse/","title":"TiNO-stents versus DES bij ACS: IPD meta-analyse","title_en":"Titanium-nitride-oxide-coated vs. drug-eluting stents in acute coronary syndromes: an individual patient data meta-analysis.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":[],"journal":"European heart journal","doi":"10.1093/eurheartj/ehaf098","source_url":"https://doi.org/10.1093/eurheartj/ehaf098","authors":["Thabo Mahendiran","Frederic Bouisset","Pim Tonino","Nico H J Pijls","Jussi Sia","Kari Kervinen","Fernando Rivero-Crespo","Peter Jüni","Bruno Roza da Costa","Carlos Collet","Takuya Mizukami","Pasi Karjalainen","Bernard De Bruyne"],"significance":5,"published":"2025-06-09","source_date":"2025-06-09","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/pci-percutane-coronaire-interventie/"],"congress":"","summary_en":"An individual patient data meta-analysis compared titanium-nitride-oxide-coated stents with drug-eluting stents in acute coronary syndromes over 5 years. TiNO stents showed comparable outcomes, offering an alternative when prolonged dual antiplatelet therapy is contraindicated.","created":"2026-07-03T10:31:40Z","updated":"2026-07-03T13:30:40Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"IPD meta-analyse vergeleek titanium-nitrideoxide-gecoate stents met drug-eluting stents bij ACS. De coating-only stents gaven vergelijkbare resultaten, wat ze een alternatief maakt bij DAPT-beperking.","abstract_original":"BACKGROUND AND AIMS: In acute coronary syndromes (ACS), vascular healing at the site of implantation of drug-eluting stents (DES) can be delayed. Titanium-nitride-oxide-coated stents (TiNOS) demonstrate faster strut coverage without the excessive intimal hyperplasia observed with bare metal stents. The 5-year outcomes of patients presenting with ACS, randomized to receive either TiNOS or DES, were compared. METHODS: A systematic review and individual participant data meta-analysis of trials comparing TiNOS with DES for the treatment of ACS was conducted (PROSPERO: CRD42024514342). The primary endpoint was major adverse cardiac events (MACE) at 5 years, a composite of cardiac death (CD), myocardial infarction (MI), and ischaemia-driven target lesion revascularization (TLR). Pre-specified secondary endpoints included CD, MI, TLR, and stent thrombosis. Data were pooled using a mixed-effects Cox regression model with random slope and stratified baseline hazards. RESULTS: Patient-level data (n = 2743) were obtained from three randomized controlled trials (TiNOS: n = 1620 vs. DES: n = 1123). After a median follow-up of 4.93 years, there was no significant difference in the primary endpoint between TiNOS and DES (12.6% vs. 16.2%; hazard ratio [HR] .82, 95% confidence interval [CI] .67-1.00, P = .051), mainly due to a similar rate of TLR (8.0% vs. 8.1%; HR 1.05, 95% CI .80-1.38, P = .733). However, TiNOS was associated with significantly lower rates of CD (1.5% vs. 3.7%; HR .46, 95% CI .26-.81, P = .007), MI (5.2% vs. 9.6%; HR .56, 95% CI .42-.75, P < .001), and stent thrombosis (1.1% vs. 3.8%; HR .30, 95% CI .17-.53, P < .001). CONCLUSIONS: In ACS patients, TiNOS was associated with similar rates of MACE and TLR as compared with DES but significantly lower rates of CD, MI, and stent thrombosis."}